Posted by dr-gwenn on February 26, 2008 at 03:31:54 PM

From the files of "tell me something I don't already know", comes this study. The headline is sure to catch the attention of every parent of a teen, or tween for that matter: "Teen Brain May Be Wired for Moodiness".

I could have told them that! In fact, they could have videotaped my morning today for a wonderful example. One minute we are happily eating breakfast and the next my 13 year old is grabbing her backpack and huffing out the door as her friend arrived to walk to school. The instigating event: her sister had asked her to move her backpack from the breakfast bar so she could have room to eat, and my 13 year old felt that request was "inconvenient". It was a lovely family moment.

Softpedia has a great summary of other brain changes in teenagers that explain just about every behavior we've all seen in teens from poor judgment to impulsiveness. The part you'll love the most is this:


Following close behind in teen news, this posted on  MomLogic today. This may surprise you, that tween swearing is on the rise. Keep in mind that tweens are 8-12 year olds. Having a tween at home and a very new teen, who only months ago was a tween, I can attest to the validity of this observation. Keep in mind that kids are sponges for what their peers do so even if you have the cleanest language at home, they will talk the talk of their buds at school. Kids this age want to fit in and to fit in means to sound the right way.

So, what's a mom and dad to do? Help them develop a filter so that the potty mouth doesn't become a bad habit. Do so by example but also by pointing out to them how other kids sound when they talk that way. Perhaps allow some "safe" words once in a while but draw the line on words that are clearly dirty, degrading or just down and out evil.

By the way, there are role models in pop culture for some rather funny ways to let off steam without cursing. In Hannah Montana they say "sweet niblets" instead of curses and all of us have started saying that in lieu of more colorful words.


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Posted by dr-gwenn on October 9, 2007 at 03:49:55 PM

There was a poignant line in Brothers and Sisters last night. Senator McCallister's campaign director felt he needed to be more positive and asked suggested he stopped attending funerals of soldiers. At the end of the show, McCallister turned to his campaign director and said: "To answer your questions about when I'll stop going to funerals. I'll stop when the last soldier is home." 

It is easy to forget that the Iraqi conflict is about real people and real families but that is what we have to keep our focus on. The show last night aired some serious issues about the battles soldiers face when they return home - the medical and emotional issues and the toll on the family including the lost feeling they feel.
Sesame Street last week announced that they are developing a DVD to help children whose parents have been injured during war. In the DVD, Rosita's daddy loses a leg and comes home an amputee and is seen in the DVD in a wheelchair. The children of soldiers are soldiers themselves and I applaud Sesame Street for recognizing the special and unique emotional issues young children have when grappling with the tough issues that war creates for their family. 

Developmentally, kids relate to furry creatures and pretend words often better than their own parents. Having a tool such as Sesame Street to help these children understand what is occurring in their world will be a great asset to parents struggling to explain to young children a situation where words become difficult. In fact, as the AP story points out, parents often use too many words which can be overwhelming to kids. According to the experts interviewed in the AP story,

"There is no more credible voice for 3- to 5-year-olds than the voices of Elmo ... and parents trust him too." Arsht said. Army Maj. David Rozelle agreed. An amputee who spends time counseling others, Rozelle was injured in Iraq before becoming a parent to two young children. "These little people our kids trust so much can explain limb loss and help kids cope," he said. "We don't do it very well ourselves."

This is not the first DVD Sesame Street developed for military families. Last year they developed a DVD on deployment, an issues that has touched over a million children over the last 6 years. With the amount of issues military families are dealing with, it is very reassuring that the military has found resources to meet the needs of all it's members and is willing to think outside the box. 

Image: AP Press on Yahoo!

Posted by dr-gwenn on August 17, 2007 at 10:26:29 AM

With cold and flu season upon us (yes, I know, you are still wearing shorts but before long that will change!), there is no time like the present to remind ourselves that small children should not use cold and cough medications. I talked about this a few months ago after the FDA warned us of the dangers of popular over the counter cold and cough medications in infants and toddlers.


In October, the FDA is convening an advisory panel to look into the safety of these drugs much more closely. The FDA is particularly concerned with drug dosing and helping parents give the proper medication doses to their children. To this end, this week, the FDA released a Public Health Advisory on Nonprescription Cough and Cold Medicine Use in Children emphasizing the need for parents to follow the labels closely, especially the "Drug Facts" box. The goal is to give the proper dose of medication and to avoid giving too much of a dose to a child.

Additional FDA recommendations from the advisory include:

• Do not use cough and cold products in children under 2 years of age UNLESS given specific directions to do so by a healthcare provider.

• Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children (sometimes called “pediatric” use).

• Cough and cold medicines come in many different strengths. If you are unsure about the right product for your child, ask a healthcare provider. * If other medicines (over-the-counter or prescription) are being given to a child, the child’s healthcare provider should review and approve their combined use.

• Too much medicine may lead to serious and life-threatening side effects, particularly in children aged 2 years and younger.

• For liquid products, parents should use the measuring device (dropper, dosing cup or dosing spoon) that is packaged with each different medicine formulation and that is marked to deliver the recommended dose. A kitchen teaspoon or tablespoon is not an appropriate measuring device for giving medicines to children.

• If a measuring device is not included with the product, parents should purchase one at the pharmacy. Make sure that the dropper, dosing cup or dosing spoon has markings on it that match the dosing that is in the directions in the “Drug Facts” box on the package label, or is recommended by the child’s health care provider.

• If you DO NOT UNDERSTAND the instructions on the product, or how to use the dosing device (dropper, dosing cup or dosing spoon), DO NOT USE the medicine. Consult your healthcare provider if you have questions or are confused.

•  Cough and cold medicines only treat the symptoms of the common cold such as runny nose, congestion, fever, aches, and irritability. They do not cure the common cold. Children get better with time.

• If a child’s condition worsens or does not improve, stop using the product and immediately take the child to a health care provider for evaluation.

So, next time your small child starts to cough or sniffle, resist the temptation to treat. The stuff causes more harm than good. A humidifier, saline nose spray and TLC from you will go much further than anything you think you are getting from a cough medication.

Since we are not officially in the cold and flu season, I have a feeling this is the first on many posts on this topic for the upcoming season. For now, just tuck this away for future reference and enjoy the rest of your summer. I'll be on vacation for a week but will be back soon.

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Posted by dr-gwenn on August 15, 2007 at 03:11:30 PM

This is getting really scary. First Fisher-Price. Now Mattel, the parent company itself. The Mattel scare announced today is even more alarming because the risk to kids more immediate and potentially fatal. Thankfully, no child has been injured by any of these toys but the toys being recalled have elements that have caused fatalities in the past so this is not a false alarm. According to the official press release from Mattel's website, there are two groups of toys being recalled that are actually expansions of past recalls:

"Mattel, Inc. announced today that the company has voluntarily recalled one toy from the "CARS" die-cast vehicle line ("Sarge" character), manufactured between May 2007 and July 2007, containing impermissible levels of lead. The recalled vehicles include 436,000 total toys, including 253,000 in the U.S. and 183,000 outside of the U.S.

...Additionally, Mattel announced the voluntary recall of magnetic toys manufactured between January 2002 and January 31, 2007, including certain dolls, figures, play sets and accessories that may release small, powerful magnets. The recall expands upon Mattel's voluntary recall of eight toys in November 2006 and is based on a thorough internal review of all Mattel's brands. Mattel is recalling 18.2 million magnetic toys globally (9.5 million in the U.S.); however, the majority of the toys are no longer at retail."

The lead we've already discussed. Lead can cause harm and if you're child has ingested paint from these products call your pediatrician to arrange a blood test, but don't panic if your child has just played with the toy. The ingested magnets can cause serious intestinal issues. Parents concerned their child may have swallowed a magnet should alert their pediatrician immediately. A simple xray can detect if indeed the child had swallowed the magnet and next steps can be taken to remove the magnet. If you are on sure if your child swallowed the magnet but have that toy in the house, alert your pediatrician if you see parts missing from the toy and your child complains of any tummy aches. Information on what to do about products being recalled can be found here, on the Mattel Recall site. This site is worth checking out and includes a nice video statement by Mattel's chair, Bob Eckert. They are as shocked as we are.

The American Academy of Pediatrics also has some excellent information on their web site that they posted today: AAP Major Toy Recall Information Page

I'll post more as new information becomes available.

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Posted by dr-gwenn on August 2, 2007 at 06:56:41 PM

A huge Fischer-Price toy recall was announced yesterday. Over 1 million toys made in China may contain excessive amounts of lead paint which as you know is toxic to small children and infants. The toys were sold between May and August, 2007 and represent Nickelodeon and Sesame Street characters.

Here are the key links to sort out if you have the toys being recalled:
Mattel Recall Information Page
List of Nickelodeon and Sesame Street Toys with the Lead Paint Hazard

The American Academy of Pediatrics recommends that all kids get screened for lead between the ages of 1-2. Some kids may get screened again if they live in older homes depending on their risk. If you have these toys at home, and your kids have not played with the toys, you have little to worry about. However, if your kids have been playing with these toys, there still may be nothing to worry about. If your kids have been playing with the toys properly, there is little risk to them. The risk comes when they ingest the lead paint. So, it's the small kids who put the toys in their mouths or who crawl on the floor near the toys where some paint may have chipped off.

If you have one of the recalled toys, follow the procedure for returning the toy, clean your floors well to remove any dust from the toy that may have rubbed off the toy, and call your pediatrician. Likely nothing more will need to be done but your pediatrician can sort through with you based on the ages of your kids and how your kids were playing with the toy whether a lead test is needed or not. But, don't worry too much, it takes a huge amount of exposure to lead to get lead poisoning. If the toy looks intact, the exposure is likely very low if at all.

Here are some lead poisoning resources which may help allay any more concerns you may have:

Information on Lead Poisoning
Testing for Lead Poisoning

Image: Mattel Web Site

Posted by dr-gwenn on July 13, 2007 at 01:45:16 PM

Talking to people about their summer plans, I've come up with a new term that I think could become a new diagnosis if the trend continues:  Shrinking Vacation Syndrome, or SVS.

Sadly, people do not seem to put a priority on family vacations any more.The answers are always similar variations of the same few themes:
no time, no money, kids too young, kids too old. Work needs me too much. (I love that one!) No one to watch the kids.
We earn vacation yet don't take it, unlike every other country in the world.  At the same time, we are also the only civilized country that doesn't guarantee vacation to employees. No wonder we are all so stressed.

Vacation is as vital to our beings as breathing, eating and sleeping. Vacation is how we regroup as individuals and family. Vacation is not frivolous or a waste of time. In fact, vacation is how we sharpen our senses so we can become more efficient when we do work.

For families, vacations allow for reconnection which is so important with lives becoming busier for parents and kids. For couples, vacations are a time to reclaim intimacy that busy lives and kids often make challenging. Remember, you were a couple before you were parents and always need to keep that in your line of sight. Vacations, even miniones, are a way to accomplish that!

As a pediatrician, I worry about the overall health of a family when I hear a family has not planned even a short get away. Even with young kids in tow and tight budgets there is a lot you can do to escape the rigors of daily life without spending a lot of money.

1. Stay at home and do day trips. Explore your back yard as it were.
2. Do a local overnight at a budget hotel or moderately priced hotel. With young kids, many hotels offer package that are really affordable.

Whatever you do the key is to break from your routine and to unplug – no cell phones, no ipods, no computers, emails, work contacts whatsoever!

For me, I need to not be near my computer – the temptation to write is too great. I do, however, bring an old fashioned pen and paper to jot down ideas for later posts and articles. As a writer, I realize inspiration may hit at any time but I don’t pursue it in any great length beyond an old fashioned pen and paper.

For my husband, he can’t be connected at all if he is to relax. His company has a way of tracking him down by his blackberry any where, any time. My Treo has limitations in cell coverage which I love! His Blackberry, on the other hand, seems impervious to those restrictions and seems to be able to penetrate even high mountains, time zones and international barriers. We take it on vacation when traveling alone to be able to have relatives reach us for emergencies for the very reason of its coverage but keep it in the safe and OFF at all other times.

By the way, I’ve written about this topic often over the years. Here are some links to other articles on this theme that you may find interesting:

Slow Down In Life To Be a Better Parent and Person

Work Together As A Family To De-stress

By the way, we took a few days around the July 4^th holiday and basically had a home-based vacation. We played tennis and golf. We had barbecues as a family – just us without importing friends and family. And, it felt like a vacation. When home, it is easy sometimes to give in to group events but we decided to lock the doors and just hang as a family unit and had a blast. Give it a try – spend time just with your own kids and each other. You really don’t need to do more than that to unwind – and it can be done within your own 4 walls!!

I found a plaque a few years ago in an ER that says it best:

A hundred years from now…it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove…but the world may be different because I was important in the life of a child

~Kathy Davis

It really is that simple. Where kids are concerned, whether Rome, Cape Code or the Nile, all they will remember in the end is time with you. That, to them, is their ideal vacation. But, do take a “real”vacation once in a while. You all need to get away from those walls, too.

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Posted by dr-gwenn on July 2, 2007 at 12:08:41 PM

Getting ready for work the other day, my 12 year old developed an ear ache. I knew it was nothing serious given her age and the fact that only minutes before she was fine. Yet, the temptation was too great to not take a quick peek.  That is the blessing and curse of being a doctor-mom! So, peering in I confirmed what I already knew:  nothing was going on.  True, she had a tad of fluid from allergies but I didn't need an otoscope to know that since she was a known hay fever sufferer and the pollen count was through the roof that week. A touch of over the counter ibuprofen and allergy meds later, she was on the road to feeling better and without a "real" doctor's visit.
 

It occurred to me  as I was driving to work that my day would likely be filled with similar complaints, as typical.  Despite the fact that most kids truly are well, parents often have times believing in that wellness and come in very quickly at the first sign of trouble, or perceived trouble. You may think that this is because they are not doctor-parents but education doesn't seem to be a factor for the "must run to the doctor" switch to get thrown. 

Intellectually, many of these parents often begin the visit by telling me they recognize I will likely find "nothing". Parents have also caught on that antibiotics are not quickly prescribed these days nor are xrays obtained that often for most injuries.  Moments like this beg many questions such as why parents have trouble believing in the wellness of their kids and why as a medical profession we haven't been successful in helping parents feel comfortable with the same watchful waiting approach they use with themselves, the very one I used with my daughter.

True to form,  my schedule that day was as predicted. At least half the patients I saw that day could have stayed at home. I saw the cough that had been present for 2 days. I saw the back pain that began that day after a flip. I saw the sore throat for 12 hours and the ear pain for 3 hours.  Among these, there were also other visits that clearly needed to be seen that day such as a few small children with very high fever, coughs that had been present for over a week getting worse and now with fever, car accidents with concerning symptoms. 

What drives parents to come in for the truly sick kids is always clear, but for the well kids I'm still at all loss to truly understand. I suspect that our inability to be comfortable with our kids wellness comes from our anxiety over the crazy lives we often lead and worrying about taking time out later for something missed. I also suspect that many parents operate out of a sense of guilt for not being home earlier in the week so at the first sign of trouble they worry that they may have missed something earlier. 

All we can ever do is assess the situation as it is today. If your child looks well, not sick appearing, what ever the complaint is likely not as urgent as your anxiety may lead you to believing.  Given that most situations in pediatrics are self-resolving and that most illnesses are viral, you really have more time than you may realize to let a situation evolve, assuming your child is otherwise well. The key here is the wellness factor. That should be your overall guiding principle - not guilt or anxiety or a sense of missing something. Believe in your child's wellness and in what your child actually tells you.

Health care is complicated and health visits only helpful when they tell you something you don’t already know. With our health care system over loaded one way we can help each other out is to begin to trust our instincts more and not use the doctor’s office for reassurance for what you already know as parents – phone calls and phone advice and often accomplish that for you more times than not and help guide you to when you really need the office visit. 

We are always there for you but in the end I always sense parents are frustrated when we don’t find something but if you come to us hunting for a needle in a haystack, and get the needles, please don’t be upset with us. There is really only so much we can do.

Summer is here and I hope I see less of you than more of you.  Keep in mid that my colleagues and I will always see your child if you want us to, but in my world, seeing you means your kids are sick or injured and my wish is always for healthy kids.

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